Tramadol is used for moderate pain and works through a combination of weak opioid activity and inhibition of serotonin and norepinephrine reuptake. It is often prescribed when non-opioid medications are not sufficient but before moving to stronger opioids. Compared to traditional narcotics like hydrocodone or oxycodone, it generally has lower potency and lower risk of respiratory depression, though it still carries dependence risk. It can be a useful step-up option for pain control, particularly when trying to limit stronger opioid use. However, it has unique risks including seizures and serotonin syndrome, especially in certain patients or when combined with other medications.